Anticoagulation Therapy in Patients Suffering from Aneurysmal Subarachnoid Hemorrhage: Influence on Functional Outcome-a Single-Center Series and Multivariate Analysis

IntroductionFavorable outcome in patients presenting with aneurysmal subarachnoid hemorrhage (SAH) is determined by several factors. Nevertheless, data on the influence of prior use of oral anticoagulation drugs on functional outcome in patients suffering from SAH are scarce. We therefore analyzed our institutional data.MethodsFrom January 2009 to October 2015, 480 patients suffering from aneurysmal SAH were admitted to our institution. Information including patient characteristics, treatment modality, aneurysm size and location, radiologic features, and functional neurologic outcome was assessed and further analyzed. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favorable (mRS 0-2) versus unfavorable (mRS 3-6).ResultsOverall, 17 of 480 patients suffering from aneurysmal SAH were on anticoagulation therapy before ictus (4%). Patients without anticoagulation therapy were significantly younger compared with patients with anticoagulation therapy before SAH (P = 0.005). Furthermore, patients without anticoagulation therapy presented in a significantly better clinical condition compared with patients with anticoagulation therapy before SAH (P = 0.02). Additionally, patients without anticoagulation therapy achieved significantly more often favorable functional outcome compared with patients with anticoagulation therapy before SAH (P = 0.02). However, anticoagulation therapy was not identified as a significant and independent predictor for unfavorable outcome in the multivariate logistic regression analysis.ConclusionAnticoagulation therapy has not been identified as a significant and independent factor influencing functional outcome in patients suffering from SAH. Therefore treatment should not be omitted. Nevertheless, cautious management is necessary in patients with known anticoagulation therapy before SAH.